肺腺癌靶向治疗后T790M突变1例
| 作者: |
1安晓彩,
1杨春霞,
1张龙,
1许爱国
1 郑州大学第一附属医院呼吸与重症科三科，郑州 450000 |
| 通讯: |
许爱国
Email: aiguoxu@hotmail.com |
| DOI: | 10.3978/j.issn.2095-6959.2019.12.043 |
摘要
分子靶向药物治疗是晚期非小细胞肺癌的有效治疗手段。以表皮生长因子受体(epidermal growth factor receptor，EGFR)作为靶点的表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitor，EGFR-TKI)，对EGFR基因突变的肺腺癌患者治疗效果显著。然而长期使用EGFR-TKI类药物，患者极可能出现耐药性，因此反复进行基因检测，并结合患者病情现状调整治疗方案，有利于控制该病的进展。本文报道1例肺腺癌晚期患者在服用第一代EGFR-TKI类药物并结合其他治疗手段治疗20个月后，再次行基因检测示EGFR基因第20外显子发生错义突变(也称作T790M突变)及突变后的诊疗过程，并对其治疗进行简要分析及探讨。
关键词：
肺腺癌；靶向治疗；表皮生长因子受体酪氨酸激酶抑制剂；T790M突变；耐药
T790M mutation following targeted treatment in lung adenocarcinoma: A case report
CorrespondingAuthor: XU Aiguo Email: aiguoxu@hotmail.com
DOI: 10.3978/j.issn.2095-6959.2019.12.043
Abstract
Molecular targeted therapy is efficacious for patients with advanced non-small-cell lung cancer. Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), regarding EGFR as a target, have great therapeutic effect for lung adenocarcinoma with the EGFR genetic mutation. However, patients treated with EGFR-TKI medicine for a long time, may develop drug resistance, and it may make the disease serious. So it is helpful to control the progress of the disease for adjust the treatment plan exactly, based on the repeated genetic testing and the present situation of patients. This paper reported that a patient with advanced lung adenocarcinoma took the first generation of EGFR-TKI drugs and was received other treatments for 20 months, then did a genetic testing again which showed the exon 20th mutation in EGFR (known as T790M mutation), and briefly analyzed and discussed the treatments.
Keywords：
lung adenocarcinoma; targeted treatment; EGFR-TKI; T790M mutation; drug resistance